Category Archives: Healthcare

Presidential Failures to Mend the Gaps

Over the course of 2018, the Trump administration set numerous policies into motion that are sure to harm vulnerable communities and exacerbate the gaps in our society. Our spirit-filled network took action to denounce the harmful actions taken by the Trump administration and prevent them from going into effect. By writing and submitting comments on proposed rules in the federal register, organizing and attending protests, and raising awareness of these issues, you acted in solidarity with the individuals and families impacted by these unjust decisions.

Healthcare

In January 2018, the Trump administration announced that the Centers for Medicare and Medicaid (CMS) would begin approving states’ requests to impose burdensome Medicaid Work Requirements. Since then, work requirements have been approved in five states, and are pending in ten more states. These work requirements target already vulnerable low-income adults, many of whom are already working or doing their best to secure steady work that pays sufficient wages.

Nutrition

The Agriculture Department released a proposed rule to enforce stricter SNAP (Supplemental Nutrition Assistance Program) Work Requirements right at the end 2018. This happened just after Congress had finally reached agreement after months of bipartisan negotiations, resulting in a majority of Congress voting to not include these restrictive work requirements in the Farm Bill. This unilateral action from the administration is clear rejection of Congress’s hard-won, bipartisan agreement.

Census

President Trump’s Secretary of Commerce Wilbur Ross announced they would be adding a Citizenship Question to the 2020 Census just as it nears the final stages of preparation. The addition of a citizenship question is likely to further depress Census responses from communities of color (which are already undercounted), due to fear of immigration enforcement in the current climate. Additionally, concerning information about persuasion from the White House and undisclosed communication with the Department of Justice encouraging Secretary Ross to add the citizenship question, has become public.

Immigration

In September, the Trump administration released a proposed regulation that the advocacy community refers to as the “Flores Rule.” This new regulation would dismantle the current “Flores” standards, now allowing the indefinite detention of immigrant children and families, including asylum seekers. In addition to being morally reprehensible, this proposal rejects proven alternatives to mass detention, which are more humane and effective. This proposed rule would allow the federal government to set their own standards for holding families and children in detention and undermine independent oversight of conditions; it also reduces vulnerable families’ access to due process and humanitarian protections.

The Trump administration’s proposed “Public Charge” Rule, published in October, would make it more difficult for immigrants to apply for and receive legal immigration status in the United States. This proposed rule seeks to drastically redefine what it means to be a “public charge” in the immigration system. This would increase the probability that legal immigration applications would be denied based on factors such as age, health, family status, financial status, education, skills, and employment history and would hurt and potentially separate families. Even the threat of this rule is already causing parents to choose between needed public assistance to keep their families housed, fed, and healthy or making their family vulnerable to separation.

Throughout the year, the Trump administration has threatened immigrants with legal status through two programs. Temporary Protected Status (TPS) is a legal immigration status for nationals of a country experiencing ongoing armed conflict, environmental disaster, or another extraordinary and temporary condition. Deferred Enforced Departure (DED) allows foreign nationals to be protected from deportation and have the opportunity to work. Currently, the Trump administration is in the process of ending protections for TPS or DED holders from 11 countries. Many of these TPS/DED holders have been here for more than 20 years, have families in the United States, and would continue to face conflict or other difficult conditions in their home countries.

Judicial

The Senate approved 66 of President Trump’s Judicial Appointments in 2018, including Supreme Court Justice Brett Kavanaugh. This is a significant number of appointments and these confirmations will have a strong impact on the makeup of our judicial system.

This story originally appeared in the January 2019 issue of Connection Magazine. Read the full issue here.

There’s a silent but deadly epidemic occurring across the United States: women are dying during childbirth at an alarming rate. The United States is the only developed country where the maternal mortality rate is rising. Pregnancy-related deaths increased from 7.2 deaths per 100,000 live births in 1987 to a high of 17.8 deaths per 100,000 in 2009 and 2011. On top of that, 50,000 mothers a year experience dangerous complications that have the potential to kill them. U.S. women had a better chance of surviving their pregnancy thirty years ago than they do today. The fact women are worse off than thirty years ago is an embarrassment and a terrifying reality for women who are choosing to start families. If we truly care for one another, we must put a special focus on this critical issue impacting women across the country.

The rising maternal mortality rate is a public health crisis that is receiving a woefully low amount of coverage and legislative responses. California is the only U.S. state that has successfully lowered their maternal mortality rate. From 2006 to 2013, the state cut its maternal death rate in half. This was accomplished by a thorough investigation of the care process, and an implementation of better practices. California hospitals work in a collaborative that shares information and best practices specifically about maternal care. In order for other states to replicate California’s success, Congress must act.

Recently the House and the Senate passed the Preventing Maternal Deaths Act, which was introduced by Rep. Jaime Herrera-Beutler, with bipartisan support and a companion bill in the Senate introduced by Senator Heidi Heitkamp. It creates maternal mortality review committees in every state that gather data and report their findings back to the Department of Health and Human Services.

(image courtesy of the Southern Coalition for Social Justice)

The U.S. healthcare system denies far too many women the care they need before, during, and after giving birth, a fact that needs to be remedied through legislation. Due to the medical racism that permeates the healthcare system, women of color are frequently ignored by providers when they advocate for their medical needs.

Black women are almost four times more likely to die of pregnancy-related causes, pointing to a shocking racial disparity. This is intensified in maternal health care deserts, where women lack access to critical healthcare. In rural and urban areas with limited OB-GYN services, women of color suffer greatly. In her congressional testimony, Stacey Stewart, the president of the women’s health nonprofit March of Dimes, emphasized that women of color often feel less trusted and feel less listened to in the medical system. She pointed to the fact that there are no obstetrical services east of the river in Washington, D.C.’s predominantly Black neighborhoods—women must cross the river to receive any sort of prenatal care. She also observed that in New York City, women of color are 12 times more likely to die as a result of pregnancy than white women. Women of color are disproportionately vulnerable to deadly pregnancy complications, making the maternal mortality crisis a horrifying manifestation of racial injustice.

In his testimony to the House Energy and Commerce health subcommittee in September, maternal healthcare advocate Charles Johnson told how he lost his wife Kira after she gave birth to their second child. Kira and Charles, a young Black couple, made sure that hospital staff were aware that Kira was bleeding heavily after her C-section. Yet the hospital waited ten hours to address her medical crisis. By the time hospital staff acted, it was too late. Kira died of massive internal bleeding, leaving behind an 11-hour-old child, her husband, and her other young child. Kira did everything right; she advocated for herself and her child throughout her time in the hospital. Despite Kira and her husband’s persistence, her symptoms were ignored until it was too late.

The CDC Foundation estimates that 60 percent of American pregnancy- and childbirth-related deaths could be prevented. The U.S. healthcare system is focused on infant health while ignoring the holistic needs of women. As a result, healthcare providers are not equipped to protect pregnant women and prevent complications that can be easily addressed under the right care. We know many of these deaths can be avoided, but we must take action to examine how our healthcare system fails women and create policies that will prevent this.

Congress has taken the first step passing the Preventing Maternal Deaths Act, which was only possible because of the continued advocacy of the public. Using this as a first step, it’s important to keep the momentum going to fight for even bigger reforms to make health care safer and more equitable. Health advocates need to make it clear to legislators that maternal health needs to be a key priority, both as we come to the end of the 115th Congress and in the new Congress. Far too many women, especially women of color, have needlessly died in this public health crisis. The only way to begin working toward a solution to this crisis is providing resources to gather more data on this epidemic so healthcare providers have the tools to prevent more tragic losses.

What to Look Out for in Lame Duck!

NETWORK Government Relations Team
November 5, 2018

The Midterm Elections are upon us — and NETWORK is busy looking ahead to the work that must be done for the rest of the year.

Members of Congress will arrive back to Washington, D.C. on Tuesday, November 13 to finish out the final legislative efforts for the 115th Congress. There are some time-sensitive issues Congress must address, as well as others that may be considered if there is time and political will. All the items on the agenda will be affected by two factors: the outcome of Tuesday’s election as well as subsequent leadership elections, especially in the House of Representatives.

With these uncertainties in mind, here is NETWORK’s analysis for upcoming issues in the final days of the 115th Congress.

Must Do: Fund the Government for 2019

Appropriations: Congress outperformed all expectations by passing 7 of the 12 appropriations bills for FY2019 before the start of the fiscal year, which began on October 1. While kudos are in order, NETWORK is urging them to pick-up where they left off as soon as they return and it’s imperative that they finish the job before the end of the year. Lawmakers have until December 7th to reach agreement on the 5 remaining spending bills which fund programs at more than 10 federal agencies, or risk a government shutdown. Several of our Mend the Gap issues are among the log-jam. These include: programs that fund the 2020 census, affordable housing and keep immigrant families together.

Border Wall

The most contentious issue will be funding for the Department of Homeland Security; which President Trump has already threatened a government shutdown if Congress fails to appropriate roughly $5 billion for his border wall. A government shut-down would be detrimental just weeks before Christmas and would coincide with the anticipated arrival of thousands of migrants trekking toward the Southern border. NETWORK has joined hundreds of advocacy organizations in calling for Congress freeze spending at FY 2018 levels for immigration enforcement officers, agents and detention beds. And we urge Congress to pass a separate short-term extension for the Department of Homeland Security. NETWORK is ready to kick our advocacy efforts into high-gear if we perceive threats around funding for our immigration and census priorities.

2020 Census

Funding for the Census Bureau, which requires a significant ramp-up for Census 2020 preparations and planning. If Congress returns to the dysfunction we saw last year with repeated funding delays via Continuing Resolutions, it could seriously threaten the ramp-up and preparations for our government’s largest peacetime undertaking, the decennial. Fiscal Year 2019 is the pivotal year leading up to the 2020 Census so postponing full funding would have dire consequences on the preparations and outcome of the count. While the proposed funding levels from the Senate and the House seem acceptable, it is unclear what the budget impact would be on the impending court ruling on the controversial citizenship question.

That being said, there are some outstanding “Maybe” issues that Congress could address: the Farm Bill, Criminal Justice, and the Low Income Housing Tax Credit.

Farm Bill: Protect SNAP

There has not been much apparent progress since the Farm Bill moved into conference in August. One of the primary sticking points in negotiations is the nutrition title and reauthorization of the Supplemental Nutrition Assistance Program (SNAP). The partisan House Bill—which passed by 2 votes on the second try—includes harmful provisions that would undermine the program’s effectiveness and cut nutrition assistance for millions of Americans. The Senate bill, which saw the strongest bipartisan support of any prior Farm Bill (86-11), makes key improvements to strengthen SNAP without threatening food security of participants. The 2014 Farm Bill expired this month but, fortunately major programs like SNAP have a funding cushion that minimizes the impact of Congress missing that deadline. It’s highly likely, though, that the Farm Bill conference committee will kick into high gear when Congress returns on November 13th. During Lame Duck NETWORK will need your help to ensure that the nutrition title from the Senate bill is what’s ultimately adopted and voted into law.

Criminal Justice

There is wide speculation that the Senate could join the House and take up a modest criminal justice reform package during the Lame Duck session, if 60 Senators agree to proceed. In May, the House passed the First Step Act, a bipartisan bill purporting to be a significant step forward in prison reform. Over the summer the President tentatively agreed to include several sentencing reform elements into a prison reform package. The Senate was split on the issue of separating prison reform from sentencing reform but has changed course given the President’s willingness to negotiate a compromise. While NETWORK supports sentencing and prison reform as a joint legislative package we did not take an official position on the First Step Act.

Read NETWORK’s thoughts on the First Step Act, from when it passed the House, here.

Low Income Housing Tax Credit

As Congress concludes work for the year, there is a tradition that of a small group of tax bills that are bipartisan, non-controversial and relatively inexpensive get passed. This group of tax bills is called “extenders.” Members of the tax writing committees are now reviewing what their priorities are for any extender bill. One of the tax initiatives under consideration is passage of “The Affordable Housing Credit Improvement Act of 2017” (S. 548) which expands the Low Income Housing Tax Credit (LIHTC) to meet the housing needs of extremely low income renter households. This credit is the primary tool to encourage private investment in affordable housing development and is responsible for 90 percent of all affordable housing developments built each year. Since it was passed in the bipartisan Tax Reform Act of 1986, the credit has incentivized the creation of 3 million affordable rental homes around the country. NETWORK will work with

Given the national shortage of affordable housing, NETWORK believes it is critical that new build more low income housing units. Passage of this bill will go a long way to meeting the needs of the homeless and other vulnerable low income individuals and families.

Thousands of Medicaid Recipients in Arkansas Lose Access to Care

In September 2018, the state of Arkansas revoked coverage for more than 4,300 Medicaid users. The state recently implemented a stringent work requirement on Medicaid recipients under the Arkansas Works program, stipulating that they must perform 80 hours of work, service, job training, or education a month. The state unceremoniously dropped recipients who did not properly log their hours into an online portal for three months. These dropped Medicaid users have no possibility of reapplying for the entirety of 2018.

This news came as a shock to the many low-income Arkansans who previously qualified for Medicaid. Due to the low profile implementation of the program, many were not aware of the new requirements. Some will not even realize they have lost their healthcare coverage until they go to the doctor or try to fill a prescription.

This is not an isolated phenomenon. Across the country, the Trump administration and its allies are encouraging burdensome work requirements for programs like Medicaid and SNAP (the Supplemental Nutritional Assistance Program). Indiana, New Hampshire, and Kentucky already received federal approval to implement their own Medicaid work requirements, while at least nine other states are considering them.

Even if Medicaid recipients in Arkansas are aware of the recent changes, they might not be able to access the Arkansas Works website to log their hours. According to the Federal Elections Commission, about a fourth of Arkansas’s population lives in areas without Internet service. The online portal has also been fraught with problems, preventing many from logging their work hours. Curiously, the website is down for 10 hours every night for maintenance, leaving it out of commission for 70 hours a week. These barriers make compliance difficult for a population already stretched thin.

It’s not as if Medicaid recipients aren’t working. At best, only 15% of enrollees not exempt from existing work requirements are not employed (Urban Institute); the vast majority are already working. The reason they are utilizing Medicaid is not due a lack of work—it is due to the deep poverty they are experiencing. Recipients do not have access to quality jobs that pay a living wage and provide health benefits.

Let’s not be mistaken—programs like Medicaid already have strict work requirements. These additional work requirements are an attempt to burden vulnerable populations with administrative barriers to affordable, quality healthcare. By dropping more than four thousand people from Medicaid coverage, the state of Arkansas stands to save 30 million a year. States like Arkansas that choose to implement these cumbersome some work requirements are choosing savings over care for their people.

Burdensome work requirements don’t address the realities of the low-income populations Medicaid serves. Work requirements don’t create stable jobs that pay a living wage, nor do they do anything to alleviate the racial income gap. Black Arkansans are twice as likely to live below poverty level than their white counterparts. These work requirements are complex in nature—they are designed to quietly dismantle social safety nets while stigmatizing low-income people as the problem. If Arkansas is serious about getting its residents off Medicaid, it needs to address economic inequality and reinvest in the working class.

The data from Arkansas gives us a look at the true human cost of burdensome work requirements. As other states roll out similar programs, thousands of people will unknowingly lose their coverage. There is no human benefit to burdensome work requirements. They only serve to harm people who utilize programs like Medicaid and SNAP to survive. NETWORK opposes implementing work requirements on our most effective human needs programs, and urges lawmakers to craft these programs to uphold human dignity, not diminish it.

Progress from Congress on Appropriations

This summer, Congress made extraordinary progress toward completing the requisite 12 spending measures for upcoming fiscal year (FY) 2019. To date, the Senate has passed nine spending bills, while the House has passed six. Lawmakers have until September 30 to finalize spending bills or extend funding at current levels through a continuing resolution (CR). Efforts are underway to bundle nine* out of 12 spending measures into three packages by September 30 and put the remaining three** bills into a CR, averting a government shutdown.

One reason for the Senate’s remarkable pace on appropriations is President Trump’s vow to not sign another omnibus spending bill. To achieve this progress, the Senate uncharacteristically spent part of August in session. Another reason is a bipartisan agreement between Appropriations committee Chairman Richard Shelby (R-AL) and Vice Chairman Patrick Leahy (D-VT) not to pack spending bills with controversial provisions that would weaken bipartisan support.

Immigration

Unsurprisingly, the Trump Administration’s “Zero Tolerance” immigration policy dominated the appropriations debate and faced strong opposition across party lines in both chambers. NETWORK joined pro-immigration advocates in garnering support for more than 12 amendments to the Homeland Security bill that adds report language that clamps down on family separation with better oversight and accountability standards for ICE detention centers. Additionally, we successfully lobbied for more funding to support alternatives to detention, family case management services, and mental health screening of unaccompanied minor children crossing the Southern border. However, a major disappointment by House Appropriators includes the reversal of the Flores Settlement, a 1997 agreement drafted by the ACLU which set a 20-day limit for family detention and governs the conditions of detention for children, including that facilities be safe, sanitary, and age appropriate. If enacted this would allow immigrant families to be indefinitely detained in facilities with harsh conditions not supported by Flores. Thankfully, the Senate approved LHHSED Appropriations bill leaves the Flores settlement agreement intact and the House language is not likely to be part of the final bill.

As for immigration enforcement spending contained in the Homeland Security Appropriations bill, the House Appropriations Committee approved $7 billion more than the Senate for Immigrations and Customs Enforcement (ICE), Customs and Border Patrol (CBP) and the Southwest Border Wall. Other areas of concern include, a 10 percent increase in detention beds, as well as funding to hire almost 800 more border and customs agents/officers.

NETWORK will continue to push back on efforts to separate families or that would undermine humane border enforcement as negotiations gain momentum post the mid-term elections.

Supplemental Nutrition Assistance Program (SNAP)

The current Farm Bill is set to expire on September 30, unless Congress passes the next Farm Bill before then or extends the current reauthorization. Regardless of when Congress finalizes the next Farm Bill, funding for SNAP will not lapse as the government is statutorily required to continue funding the program subject to participation demands. Since 2015, SNAP enrollment has declined by more than 4.7 million people resulting in a $73 billion automatic appropriation for FY 2019. This is $794 million less than FY 2018 and a 10 percent reduction since FY 2015.

Census

House appropriators gave a big boost to the Census Bureau in the FY 2019 Commerce, Justice, Science Appropriations (CJS) bill, approving nearly $1 billion more for the agency than the Senate. However, it is unclear how much of the $4.8 billion for the agency will be allocated for the 2020 Decennial. Conversely, the Senate appropriators (under new leadership) appears to have taken a more conservative approach and adopted the President’s FY 2019 budget request to fund the 2020 Decennial at $3.015 billion. This is drastically different from NETWORK’s request of $3.928 billion minimum baseline.

Besides census activities, the CJS bill also funds immigration related law enforcement and adjudication efforts within the Department of Justice. Regrettably, the House Committee bill, fails to fully protect immigrant families and includes increased funding for immigrant-related law enforcement efforts. Congress is not expected to finalize the CJS bill until sometime after the mid-term elections. NETWORK will continue to call on our supporters to push for the higher number for the 2020 Census contained in the House bill.

Housing

Funding for housing programs fared better in the Senate. The Senate approved a $12 billion increase above the President’s FY 2019 budget request−and is $1 billion above the House bill. Housing programs help nearly 5 million vulnerable families and individuals. This includes: $22.8 billion for tenant-based Section 8 vouchers; $7.5 billion for public housing; $11.7 billion for project-based Section 8; $678 million for Housing for the Elderly; and $154 million for Housing for Persons with Disabilities. Both committee bills reject the Administration’s rent reform proposal, and reinstate funding for the Community Development Block Grant (CDBG) and HOME Investment Partnerships programs, which were eliminated in the President’s FY 2019 budget request. However, the House reduces spending for the HOME program by 12 percent.

NETWORK will continue to advocate for increased funding for affordable housing programs.

Children and Human Needs

The LHHSEd Appropriations bill funds popular safety net programs, like Medicare and Medicaid operations, home energy assistance, Head Start and the Child Care Development Block Grant. It is the 2nd largest spending bill, after defense and comprises about 63 percent of total discretionary spending. The House and Senate bills are slightly different—overall the Senate bill is better because it has a higher spending allocation and contains no poison pill riders unlike the House.

Unfortunately, the Affordable Care Act continues to be attacked by Republican lawmakers. Both the House and Senate bills reduce access to affordable health care by cutting funding for the Centers for Medicare and Medicaid Services (CMS) operating budget by nearly half a billion dollars. According to the House Committee report, Democrats view defunding CMS as “a misguided attempt to sabotage the Affordable Care Act’s health insurance marketplace.” If enacted this cut would significantly impact Medicare as it subject to mandatory 2 percent sequestration cut pursuant to the Balance Control Act of 2011 (P.L. 112-25).

NETWORK will continue to call on our supporters to push back against efforts to defund the Affordable Care Act.

Attempts to Sabotage the ACA Continue

This month has been particularly rough for the Affordable Care Act (ACA). In two acts of sabotage, the Centers for Medicare and Medicaid Services (CMS) announced policy decisions that will undermine access to health care for millions of people. (You can see our coverage of previous ACA sabotage from the Trump administration this year here).

First, the administration and the Centers for Medicare and Medicaid Services sent out a notice that funding for the navigator program would be cut to $10 million for the 2018-2019 enrollment period. Navigators work on the ground to help people navigate the online Insurance Marketplace and choose a plan that is right for them. Most navigators work for non-profit companies, and are present in congregations, public libraries, and other spaces to meet the needs of their community. Navigators also provide internet access to low-income and elderly people who might not have access to a computer find affordable health insurance. In 2016, the program was funded at $62 million, and only $36 million last year.

CMS also announced that it would be ending the risk adjustment program for insurance companies on the marketplace after a narrow ruling in New Mexico. The risk adjustment program is one of the main ways people with pre-existing and complex medical conditions can gain access to healthcare. The program uses premium money from healthy people in the individual market to pay for sicker people. It doesn’t cost anything, and is one of the main ways insurance works. Without this, however, costs could skyrocket for people with pre-existing conditions. This comes as rates and markets are being set for 2019, and without the ability to spread around risk between healthy and sick patients, premium rates could increase dramatically.

However, this decision was based on one case in New Mexico, where the judge ruled that the program in the state could not continue. Previous to this, a judge in Massachusetts had found the rule legal. However, CMS decided that the New Mexico ruling applied to all twenty-three states that have their own individual marketplace programs. Additionally, the Centers for Medicare and Medicaid Services could have done a few things, including starting the appeals process or asking if the court meant for the ruling to apply to markets outside of New Mexico, that they chose not to do.

The reduction in funding for the popular navigator program, combined with the ending of the risk adjustment program, are two more acts of sabotage against the Affordable Care Act. We are seeing time and again that what the administration cannot do through the legislative process, they are doing through the administrative one.

People of Faith Working for Access to Affordable Medicine

Fran Quigley
July 5, 2018

Last June, 26 year-old Alec Smith of Minnesota died because he could not afford to treat his Type 1 diabetes with insulin that has risen in price over 1,000% since the late 1990s. One out of every five Americans does not fill a prescription each year because they can’t afford it—and risk strokes, heart attacks and unrelenting pain as a result.

Tobeka Daki of South Africa, the mother of two sons, died in 2016 because she could not afford a monopoly-protected cancer medicine priced at 193 times its manufacturing cost. The United Nations estimates that 10 million people each year die because they cannot afford the medicine to treat them.

The tragic stories of Alec Smith and Tobeka Daki could be repeated many times over in every community, and they could be told about vaccines, mental health medicines, asthma medication and nearly every other treatment. Many of us heard about the Epi-Pen 450% price increases or “Pharma Bro” Martin Shkreli’s 5,000% overnight spike in the price of the HIV medicine Daraprim. But these high-profile controversies are only the most visible symptoms of a deeply entrenched problem.

In stark contrast to Jesus bringing healing to the poorest of the poor, today’s lifesaving treatments have increasingly become a luxury that only the world’s wealthy can afford. Protected from market competition by monopoly patents, medicines are routinely priced at levels hundreds of times their manufacturing costs. The companies that sell the medicines make record-breaking profits yet still routinely raise prices by double-digit margins each year.

These companies tout their research investments, but they actually spend far more on advertising, executive salaries as high as $78 million per year, stock buybacks that enrich the top shareholders, and political campaign donations. In the meantime, our sisters and brothers are splitting their pills, maxing out credit cards just to go to the pharmacy, or simply going without their medication.

For people of faith, this status quo is unacceptable. All major religious and moral traditions embrace a clear responsibility to care for those who are poor and the sick. And that obligation goes beyond direct care to use our voices to ensure that our systems and laws do not lock out those in desperate need of medicines.

Those proposals include allowing Medicare to negotiate drug prices the same way other countries do now, and speeding the process for drugs to be available at far cheaper generic prices. The corporations setting record prices can do so only because our government has chosen to grant them private monopolies on selling taxpayer-funded developed medicines, even though nonprofit models for research and development have proven to be effective.

Advocates for affordable medicines have won before. In the HIV/AIDS treatment campaign of the turn of the century, much of the faith community joined a global moral movement that successfully overcame monopolies and reduced antiretroviral medicine prices by more than 90%, saving millions of lives in the process.

The faith community can play this role again. We start with the foundation, set out in both our sacred texts and global human rights treaties, that people who are suffering should be able to access the medicines they need. The fact that Alec Smith, Tobeka Daki and millions of others cannot access the medicine they need to live is a moral failing.

Freedom for Some, But Not for All

July 4, 1776: the day the Declaration of Independence was adopted. Since then, each July 4th we celebrate our nation’s freedom from an overbearing colonial rule and our fervent patriotism. We dress in red, white, and blue, enjoy cookouts with neighbors in our backyards, and watch from picnic blankets as fireworks erupt across the sky. Yes, the day has become commercialized, but the words of the Declaration of Independence remain as pertinent in our current political climate as they were when they were first written.

The document written by our founding fathers clearly declares our commitment to “unalienable Rights” defined as “Life, Liberty and the pursuit of Happiness.” It even goes so far as to say that when a government fails to protect these rights, it is the duty of the people to alter or abolish it, and that a leader whose actions resemble a tyrant cannot be trusted to rule and uphold the freedom of the people. Thus, we see the intricate and fragile relationship that exists between the government and the governed.

Take a snapshot of the United States at this exact moment, and you will realize that we have do not have good governance, and that many in our country still lack the rights which the Declaration of Independence deems “inalienable.” In his “I Have a Dream” speech, Rev. Dr. Martin Luther King Jr. talked about what was meant by this term: “This note was a promise that all men, yes, black men as well as white men, would be guaranteed the unalienable rights of life, liberty, and the pursuit of happiness. It is obvious today that America has defaulted on this promissory note insofar as her citizens of color are concerned.”

The default on the promise of “inalienable rights” was evident during Rev. Dr. Martin Luther King Jr.’s time and it is still evident today for people of color and all on the economic margins seeking to live freely in the United States. We see this in the recent decision by the Supreme Court to uphold the Trump administration’s travel ban, Congress’s failure to pass a Dream Act to protect DACA recipients, and state and federal attempts to impose work requirements on human needs programs that help our nation’s most vulnerable families and individuals. How do these political decisions enhance the life, liberty, or happiness of the people they impact? They don’t.

On a more personal level, we have begun to fail one another, as violent discrimination and exclusion continue to reign. Our nation has endured countless acts of police brutality and racial profiling. I am astonished on a daily basis by the attacks on communities of color, like the recent shooting of high school student Antwon Rose. If we set a standard that “all men are created equal,” shouldn’t we hold all people to that standard, regardless of race, gender, or religious beliefs?

A few days ago, one of my coworkers sent around a video from the show, Dear White People, to our staff. In the video, the character Reggie reads a poem he wrote for an open mic night—his rendition of the Declaration of Independence:

We hold these truths to be self-evidentthat all men are created equalthat they are endowed by their creatorwith certain inalienable rightsAmong these life, liberty andthe pursuit of happinessunless you’re loud and blackand possess an opinionthen all you get is a bulletA bullet that held me at bayA bullet that can puncture my skintake all my dreams awayA bullet that can silencethe words I speak to my motherjust because I’motherA bullet – held me captivegun in my faceyour hate misplacedWhite skin, light skinbut for me not theright skinJudging me with no crime committedreckless trigger finger itching toprove your worth by disproving mineMy life in your handsMy life on the lineFred HamptonTamir Rice. Rekia BoydReggie GreenSpared by a piece of papera student IDthat you had to see beforeyou could identifymeand set me supposedlyfreeLifelibertyand the pursuit of happinessfor some of us maybeThere’s nothingself-evidentabout it

The Declaration of Independence pronounced the individual rights that cannot be taken away. In 1776, that only included white, male landowners. After much hard work and sacrifice, we know that all people deserve these same unalienable rights. But, we see that as a nation today, we fall despairingly short of this. The words of the Declaration of Independence should not be an ideal or something that we aspire to. They must be the law of the land, the fabric which knits our country together. For if we cannot claim our freedom, what do we have left?

Another Republican Attempt to Attack Healthcare

Over the past few months, we have seen continued attacks and outright sabotage on the Affordable Care Act (ACA) from the Trump administration. After last summer’s failed attempt to repeal and replace the Affordable Care Act through a bill sponsored by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA), the administration moved to try and end protections through the rule-making process in the department of Health and Human Services. While the implications of the new rules are serious, and will likely cause millions of people to lose or be priced out of healthcare coverage, there is a new legislative threat looming that is eerily similar to the Graham-Cassidy plan that we saw last summer.

This plan was introduced recently by the conservative Heritage Foundation and former Senator Rick Santorum and later presented to Republican leaders. Most of the plan is the same as what we saw last summer in the Graham-Cassidy proposal. It would undo protections for those with pre-existing conditions, include annual and lifetime limits, and exclude certain essential services in health insurance plans, including maternity and mental health services.1 Additionally, it would undo Medicaid expansion and convert Medicaid funding to a block grant to the states, making it less likely that low income people will be able to access affordable coverage.1

The good news is that this is still just an idea from a conservative think tank. However, as we have seen before, Republicans in the House are serious about taking away healthcare coverage and protections from the most vulnerable.

There is concern that if this horrible idea becomes a bill, it could move quickly this summer due to a process called budget reconciliation. In this process, the budget could include instructions that would allow for Congress to pass a bill with only 51 votes, instead of the normal 60 vote majority. This is what happened last summer when the “repeal and replace” bills nearly passed in the Senate.

As people of faith, we believe that healthcare is a human right. When proposals like this threaten to take away access to healthcare from the most vulnerable among us, we will fight to stop it. We will be monitoring this situation closely to ensure that this proposal does not become a bill. If it does become a bill, we will mobilize and act to prevent it taking healthcare away from millions.